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Dr. Harry Singh explains how to ‘turn that frown upside down’ with Restylane

Marionette lines are vertical skin folds or wrinkles which start from the corners of the mouth and head in a downwards direction, eventually reaching the chin. They get their name from the mouth shape seen in marionettes, string puppets or ventrilloquist’s dummies, where a block of wood opens and closes to simulate speech from the mouth.

As we age, marionette lines will get more and more pronounced, eventually creating this puppet-like mouth appearance in older age, yet women and men in their 30s, 40s or 50s will start to notice the appearance of this ageing effect on their faces, as small creases appear at the corners of the mouth. As well as being a sign of ageing, many people dislike these lines as they have the effect of an down-turned smile or ‘frowny face’, making the individual appear unhappy or sad, even when they are not. This can cause others to comment about their need to ‘cheer up’ or affect an individual’s self confidence, ultimately having an impact on their mental health and perhaps making their emotions match their face through unhappiness or depression.

Marionette lines conincide with a loss of skin firmness, elasticity and volume in the lower face, combined with the evil that is gravity. Restoring lost volume and structure to the face can help define and support areas of laxity, such as the appearance of lines around the nose and mouth. Genetics (natural ageing), sun exposure and smoking can all cause these lines to appear and get worse, often accelerating the effects. Like many other areas of facial ageing, such as nasolabial or nose-to-mouth lines, marionette lines can be addressed effectively with the use of dermal or soft tissue fillers.

In my clinic in Stevenage, Hertfordshire, I use the Restylane range of hyaluronic acid-based dermal filler products which are temporary, clinically proven and effective. Restylane products were first used in the mid-1990s and were originally developed in Sweden. I choose this range because they have such a long history of proven science and clinical trial data which shows how safe they are to use in cosmetic treatments; which I have been performing myself for over fifteen years.

Hyaluronic acid-based soft tissue fillers not only contain a synthesised version of a natural substance that our bodies make daily to keep our skin hydrated, but they come in different thicknesses of the hyaluronic acid (HA) gel which means that they have been created to last much longer in the body compared to our natural HA, which we metabolise daily. By placing different thicknesses or gel derivatives from the Restylane range, I am able to add long-lasting volume, definition or hydration to the areas that need it most, to plump out visible folds and depressions. During a consultation we can discuss the extent of your manifestation of marionette lines and the best treatment approach, in terms of the most appropriate type of Restylane product to use, and the quantity or number of syringes needed to achieve the level of correction of the lines at the corners of your mouth. It may be that a combination of aesthetic treatments or products will achieve the best results.

Restylane HA gels normally last between 6 and 9 months before they are completely reabsorbed naturally by your body, giving you a long-lasting result which we can maintain with additional treatments at repeat clinic visits during the year.

If you are worried about looking sad due to downward lines around your mouth then please call 01438 300111 to book an appointment to see Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Dr Harry Singh explains how botulinum toxin injections, using Azzalure™ can be used to lift and rejuvenate the neck, giving you a look more like Nefertiti and less like a turkey

Ageing is a tricky process that creeps on us. Most of us start to notice fine lines and wrinkles around our eyes, tell-tale crow’s feet, then maybe a frown line or two in between our eyes, all of which signals that our faces are starting to age. You may look at your hands, often regarded as the best way to really know someone’s age, but do you ever look at your neck?

Our necks are hard-working parts of our bodies. They must hold up our head for starters. We stretch them in different directions all day long and they’re at the forefront of most of the sun exposure that we get during a lifetime, often not having all the UV sunscreen protection that would be recommended.

This means that over time, the skin on our neck become less smooth, loses volume and suffers from photo-damage in terms of changes to texture, tone and pigmentation. As this happens, the strong muscular bands that do all the work of keeping our heads up, known as platysmal bands, start to show through the thinning skin layers, giving the characteristic ‘turkey neck’ appearance.

When it comes to ideals of beauty, especially beautiful necks, you can’t help but be in awe of the bust of the Egyptian Queen Nefertiti. Granted, we have no actual ‘selfies’ of the beautiful lady to prove that the artwork done in her name was a genuine representation, but still, it shows what a beautiful, elongated, smooth neck can do for a woman and why Nefertiti was regarded as such a ‘goddess’. Given the choice of a turkey neck or having a Nefertiti lift, I think we know what everyone would choose.

Good news then, at my clinic in Stevenage, Hertfordshire we can reduce the appearance of platysmal bands, restoring a more youthful appearance to the neck, without impacting on function or neck movement, using botulinum toxin injections.

I use the Azzalure™ brand of botulinum toxin, you may also have heard of Botox®. They are both botulinum toxin type A and are also prescription only medicines which must be prescribed for you after a face-to-face consultation with me, Dr Harry Singh. I am a dentist and aesthetic practitioner, who has been performing and prescribing botulinum toxin treatments for cosmetic use for over fifteen years. This is an advanced technique for the use of Azzalure, and thus needs to be performed by a qualified and experience medical practitioner.

During a consultation, I will ask you to clench your teeth together in an exaggerated smile which allows me to see your neck muscles in full action, as well as how prominent your platysmal bands are at rest, when you are doing nothing. This will allow me to determine if this treatment will be of benefit to you. I will also take a detailed medical history to make sure that you are suitable. Depending on the severity of the lax skin, wrinkles or volume loss in your neck, I may also discuss other aesthetic treatments which can be combined for a more complete solution.

If we go ahead with botulinum toxin treatment it will be injected in very small doses into specific points along the neck muscles. The toxin will take about a week to work and will weaken the muscles ever so slightly, so they become less prominent and improve the appearance of your neck. It’s not a permanent solution, as the botulinum toxin does wear off over time, so you will require repeat treatments every 4 to 6 months to maintain the result.

Please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire if you are bothered by the appearance of your neck and we can discuss if Azzalure botulinum toxin injections are suitable for you. Please call us on 01438 300111.

Dr. Harry Singh explains how definition and a ‘strong jaw’ can be restored with Restylane

A strong jawline is an attractive aspect of both the male and female face, but it is one of the first areas where we notice ageing, as characteristically lax skin, in the form of jowls, start to appear. Men lose the strong, chiselled look favoured by cartoon super heroes and women start to look sad as jowls pull downwards at the corners of the mouth.

Gravity is our enemy and it is the jawline where all the volume loss from the mid-face starts to show as skin and tissue head south for the winter of our lives.

But, before you put your head in your hands and have a good blub at the injustices of the ageing process, there is a solution, so ‘chin up’, quite literally, and let us tell you all about jawline contouring with dermal fillers.

We have talked about the mathematical principles of beauty in the face before, the so-called ‘golden ratio’ of Phi, and the jawline is a key structure in the beautiful balance of the face. In our youth, our faces tend to be like an upturned triangle with the point being at our chin, but as we age, this triangle turns up the other way and our chin becomes part of the big baseline across the bottom as jowls take over the triangular point we once had. Redefining the area, giving structure and contouring to the jawline can give rise to a cosmetic improvement that helps bring the triangle back to the orientation we once had, restoring a more youthful aspect and improving self-confidence about one’s face.

I use Restylane which is a range of temporary hyaluronic acid-based dermal fillers at my clinic in Stevenage, Hertfordshire. Having been performing cosmetic injectable treatments since 2002, I feel confident, not only in my technique, but also in the range of products that I choose to use. Restylane is based on Swedish technology and has a safety record going back 25 years. The product range includes hyaluronic acid gel which is available at different thicknesses allowing me to achieve definition, volumisation and hydration wherever we need it, just by using a single or combination of products from the Restylane range. Thicker options such as Restylane Lyft (formerly called Perlane), Volyme and Defyne provide all the options needed to inject along the jawline to create support, restore structure and gift lift where required. The type of Restylane products required and the number of syringes recommended will depend on the levels of correction needed for your individual case, but we can discuss that during a consultation, so you needn’t be worried about coming along to find out more.

Restylane products are made from a non-animal source of hyaluronic acid, which is something that our own bodies make naturally every day. It’s like a natural moisturiser in the skin and helps to keep it hydrated, but as we age we simply don’t produce enough to do the job properly, so the facial skin starts to wrinkle and sag. Putting back hyaluronic acid, in the form of these synthesised gels, which are designed to last for 6 to 9 months, in some cases 12 months, means that we can achieve a lasting correction and help the body to hydrate and plump out the area effectively.

Restylane products also come with added local anaesthetic in the form of lidocaine, which is the same thing that the dentist might give you if you have a filling. This makes the injections into the jawline more comfortable and often pain-free for many people. As mentioned, this is not a permanent fix to the ageing of the jawline, so repeat treatments will be needed, as eventually your body will metabolise all the hyaluronic acid from the Restylane.

If you are bothered by the shape of your jawline and want to know more about using treatment to recontour and redefine it, then please call 01438 300111 to book an appointment to see Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Dr. Harry Singh explains how dermal filler products can be used to treat a recessive or weak chin and improve the overall appearance of the face.

The chin is an important, if often overlooked, part of what makes a balanced facial shape. The relationship between the eyes, nose and chin has been defined in a standard of beauty known as the ‘golden ratio’, based on the mathematical principles of Phi. Put simply, if the chin isn’t how we would expect it to be, it can really make a difference to the appearance of the whole face because the mathematical balance is lost.

Having a weak or recessive chin is very common, in both men and women, and unless it is an extreme malformation – affecting speech or eating – it is generally a cosmetic concern which can be easily addressed with non-surgical, cosmetic solutions, using dermal fillers. Cosmetic improvement in this way can help to restore self-confidence about one’s face.

Having a strong jawline is an attractive feature, in both men and women, but for some the chin doesn’t protrude far enough away from the face, appearing small or sunken back, and affecting those golden ratio beauty lines between the nose, lips and chin. A small chin can often mean that there is no clear definition between the chin and neck which can also make the mouth and lips appear oversized.

Although a minor genetic phenomenon, or a result of injury, the appearance of the chin and jawline can be enhanced by building volume and definition both in the point of the chin and along the jawline or jowl area, to increase its prominence and bring the face back into balance.

At my clinic in Stevenage, Hertfordshire, I like to use temporary hyaluronic acid-based dermal fillers that offer a safe, cosmetic solution to this concern. I’ve been administering fillers to patients for well over fifteen years now and in that time have learnt and perfected advanced techniques such as chin contouring.

Using the Restylane range of hyaluronic acid (HA) gel fillers, which have been clinically-proven for use as cosmetic tissue fillers since the early 1990s, I have a range of different gel thicknesses which means we can build volume and structure where we need it with thicker products, and then define and contour the final shape of the chin and jawline with softer, thinner types of the HA gel.

Hyaluronic acid is made naturally by our bodies every day and is a key component of our skin, attracting water and keeping skin hydrated, with a plump and youthful look. Implantation of synthesised, non-animal-based HA products, like Restylane have also been shown to stimulate the body’s own collagen formation. Restylane will build a support structure which can be added to with repeat treatments every 6 to 9 months, whilst also giving the body a helpful nudge to lay down new tissue in the area to naturally enhance and improve the chin.

Restylane products come with added lidocaine so treatment is comfortable due to the local anaesthetic. They are also temporary, meaning they are fully metabolised by your body over time. This is much better than the solution of old for chin augmentation where either permanent dermal fillers or surgical chin implants made from silicone were used.

The amount of correction needed to improve your chin will determine which Restylane products we use, as well as how many syringes are required to achieve the desired result. Maintenance treatments will be recommended to keep the correction and improvement to your chin.

If you want to discuss if dermal fillers are the right treatment for your chin, then please call 01438 300111 to book an appointment to see Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Dr Harry Singh explains how botulinum toxin injections, using Azzalure™ can be used to treat bruxism, teeth clenching and reduce the appearance of a square jaw.

Our jaw is a pretty clever thing, we move it up and down regularly throughout the day as we talk, chew, bite and yawn. It also plays an important role in creating a pleasing and attractive shape to the human face. A wide jaw, which can create a square-shaped-look to the lower face, is quite a common occurrence, and although desirable in men as a sign of strength and masculine beauty, it is not considered as attractive in a female.

The appearance of a square-like jaw, is caused by prominent masseter or chewing muscles. If you place your hands at the end of your jaw bone, just below your ears and then clench your teeth together you will feel the masseter muscles as they harden under your fingertips.

In the case of a square jaw, the masseter tend to be excessively active muscles, which means that they have become somewhat ‘pumped up’ through additional exercise, usually as a result of teeth grinding or clenching. The medical name for teeth grinding is bruxism, and it is an incredibly common condition whereby you move your jaw, usually whilst sleeping, and grind the surfaces of your teeth together. This has an effect on both wearing down the surface of your teeth, usually corrected through the wearing of a dental shield at night, but also it exercises your masseter muscles making them more bulky and strong, leading to the square jaw appearance. Thankfully though we now have a solution to both – botulinum toxin injections.

I have been using Azzalure™ botulinum toxin, which is a prescription only medicine brand just like Botox®, at my clinic in Stevenage, Hertfordshire for well over fifteen years. Although these products are most commonly used as anti-wrinkle injections for reducing crow’s feet and frown lines, botulinum toxin also has many medical and practical applications where over-active muscles or muscle spasms are causing a problem. In this case, we would use it to treat the masseter muscle to reduce its activity to more manageable levels.

As a dentist, I am very familiar with the anatomy of the jaw and have encountered many hundreds of patients over the years who regularly grind their teeth in their sleep, so I can advise you during a face-to-face consultation if prescribing botulinum toxin to treat your masseter muscles will both reduce the dental implications of your bruxism, as well as improve the square-like appearance of your jawline, if this is of concern.

Treating the masseter muscles with Azzalure is an advanced technique, so it is important that you see someone with experience, training and understanding of the appropriate dosing required and the effect on the anatomical structures. Seeing an advanced practitioner, like myself, means that you will reduce your risk from over treatment which could weaken the muscles too much and impact on the movement of your jaw and your ability to bite or chew properly, or even open and close your mouth.

Treatment for a square jaw and bruxism with botulinum toxin is not a permanent solution but will last for approximately 4 to 6 months. You will require regular, repeat treatments to maintain the correction but you should notice a reduction in the dosing required to maintain the muscle activity at a level which helps you to stop grinding your teeth and brings your face back into a more attractive shape.

Why not arrange a consultation appointment with me, Dr Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if you have over-active masseter muscles which could benefit from Azzalure injections; please call us on 01438 300111.

Dr Harry Singh explains why botulinum toxin injections, using Azzalure™ could be the right solution for you if you have smoker’s lines around your mouth.

Do you, or have you ever smoked? If the answer is yes, then you’re probably expecting a lecture about how bad smoking is for your lung health, but that’s not what I want to talk about; I want to talk about smoker’s lines.

Smoking is actually pretty bad for your skin too, and is a significant contributing factor to the premature ageing of your skin, alongside sun exposure. The effects of smoking start to show after about a decade of the habit, speeding up normal ageing and leading to the early appearance of wrinkles. This is because the nicotine in the cigarettes causes a narrowing of the blood vessels that supply the surface layers of your skin. This reduction in blood flow means that the skin cells don’t get as much oxygen or vital nutrients needed to support them and keep them healthy. It’s also been shown that many of the other chemicals present in tobacco smoke damage the collagen and elastin found in your skin; these are your skin’s support structures, so when they get damaged skin starts to sag and wrinkle.

Finally, I know, it’s starting to sound like a lecture isn’t it; the physical act of smoking, and the facial expressions made can also lead to the production of certain dynamic wrinkles. As you suck on and inhale from a cigarette, much like a straw, you purse your lips, leading to the formation of straight-line wrinkles in the area which surrounds the top and bottom lips, usually worse above the top lip, under the nose. After many years of smoking, these lines don’t just appear when you smoke, but are present when your face is at rest and you are not moving your mouth. It is these lines which are referred to as characteristic smoker’s lines. Similarly, you may also squint your eyes to avoid the smoke as you inhale and this adds to the formation of crow’s feet and frown lines.

All in, being a smoker will lead to you looking old before your time.

Now, of course I would advise you to quit the habit and your NHS GP can help you with solutions to achieve that, but what I can offer is a solution to the premature ageing and wrinkles associated with smoking.

During a face-to-face consultation with me, Dr Harry Singh, at my clinic in Stevenage, Hertfordshire, I can assess your medical and smoking history, current health and the presence of smoker’s lines. If botulinum toxin injections are the right solution for you, I can prescribe them as a cosmetic treatment. I use a brand called Azzalure™; Botox® is another brand that you may have heard of too. This prescription medicine can be used as an anti-wrinkle treatment for crow’s feet, frown lines, forehead lines, bunny lines around the nose, and smoker’s lines around the mouth. Treating these lines is an advanced technique, so it’s important that it is performed by someone with advanced training and experience. As a dentist, I understand the anatomy of the mouth area and have been performing cosmetic injections for over 15 years.

Azzalure acts by reducing the strength of certain muscles, in this case the large muscle that circles the lips, so that the production of the dynamic lines associated with smoking is reduced, and the overlying skin does not form the lines so readily, allowing it to recover and the wrinkles to reduce in appearance. Because this is a very important muscle for other actions such as speaking, smiling, drinking, chewing and kissing, we use very small doses of the botulinum toxin to reduce the smoker’s lines without affecting anything else. Treatment is not a permanent solution, lasting 4 to 6 months, but with regular injections we can prolong the recovery of the skin in the area and the lines will continue to fade.

If you are concerned about smoker’s lines and want to discuss whether Azzalure injections could be suitable for you, please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire by calling 01438 300111.

Wondering where your temples are? You’re probably not the only one as it is an area of the face which doesn’t get discussed all that much, especially when it comes to cosmetic enhancements.

The temples, yes there are two of them, one on either side of your face, are the small flat areas that you will find if you place your fingers just above your crow’s feet area, in line with the tops of your ears, and just below where your forehead starts.

The temporal region, as it’s medically called, is quite bony with little volume in terms of fat compared to say the cheeks where you can pitch a good amount of tissue if you try. Yet, as we age, the temples start to lose the small amount of volume they have, and this affects the overall appearance and youthful aspect of the face.

A youthful face is round or oval, with a ‘full’ appearance to the shape. As we age, the overlying tissue and the bone density of the skull changes and this leads to a loss of this fullness. The easiest way to explain this is that the face goes from a round or oval shape to a ‘monkey-nut’ appearance with a distinct concavity or dent in the shape of the face. This changes the face from a youthful appearance to a more skeletal, aged look.

Correcting the hollowing of the temples due to this volume loss can be done with dermal fillers, the same products often used to augment lips, recontour the jawline, plump up cheeks and correct nose imperfections non-surgically. However, the temple area is also considered to be one of the more complex areas of the face where a good knowledge of the underlying anatomy is paramount, so any practitioner performing temple fillers should have advanced training and experience. I use hyaluronic acid-based dermal filler products at my clinic in Stevenage, Hertfordshire and have been performing cosmetic injectable treatments, including advanced techniques for over fifteen years.

Usually, adding dermal filler products to the temples will not be a stand-alone treatment, but part of an overall facial rejuvenation treatment. The temples also affect the structure around them so adding volume back, which will return the round-ness of the face, can have secondary effects such as lifting the side of the brow area and can also lessen other changes in the lower face affecting the cheek and nose-to-mouth (naso-labial) lines. Often overlooked, you may be surprised to discover how much difference can be achieved with some hyaluronic acid gel to the temporal region.

Hyaluronic acid (HA) is a natural component of human skin and something that our body makes daily. Our bodies need to produce lots of HA because it acts as a natural moisturiser, drawing in water to our skin to keep it plump and hydrated, but our natural HA doesn’t last very long before we metabolise it and then need to make more. Unfortunately, as we age, we are not able to produce as much HA as we did in our youth, so skin becomes dehydrated and less plump. Some clever scientists have synthesized HA from non-animal sources so that it is safe for use in humans. The difference being that the injectable HA is made into a longer-lasting gel, so it stays within the tissue for much longer than our natural hyaluronic acid.

I use the clinically-proven Restylane range of dermal fillers which has been proven to be safe and effective since the early 1990s. Restylane comes in different HA gel ‘thicknesses’ for use in different areas of the face to achieve maximum volume replacement and contouring. It also comes with the local anaesthetic lidocaine for a more comfortable treatment. By using these products in the temporal region, as well as other areas which could benefit from rejuvenation and volume correction, you can expect an improvement in your facial appearance to last between 6 and 12 months. We can then come up with a bespoke treatment plan to maintain the correction with future appointments at Aesthetics in Stevenage, Hertfordshire with me, Dr Harry Singh.

If you want to discuss if temple fillers are the right treatment for you, then please call 01438 300111 to book an appointment.

Dr. Harry Singh explains how dermal filler products can be used to give you the cheek ‘bones’ you always dreamed of.

Well-defined cheek bones and the plump pockets of fat which sit above them are a key facial structure and an important element of what makes a face look beautiful. This area represents a point of beauty in a woman and defines a strong face in a man. As we age we lose both elasticity in our skin and fat or volume from the face, leading to a less-balanced, less-youthful and undefined facial profile.

This volume loss leads to a loss of cheek fullness and goes on to impact in the direction of gravity to create a sagging jawline and an overall dower look. Augmenting or enhancing the cheeks, in both men and women, can put back the lost volume, instantly raising the face and bringing back a more youthful look. We can achieve this using dermal fillers which create a more natural improvement in the face than traditional solutions of the past such as surgically placed cheek implants.

I use hyaluronic acid-based dermal filler products at my clinic in Stevenage, Hertfordshire. Specifically, I use different thickness dermal filler products from the Restylane range which has been clinically-proven for cosmetic use since the early 1990s. Restylane products have one of the longest records for safety and efficacy of any dermal filler brands.

So, what is hyaluronic acid? It is a natural component of our skin and we make it daily to aid hydration and keep our skin plump and young-looking. Hyaluronic acid is a natural sponge and it draws in water to an area of tissue. Unfortunately, as we age we produce less and less of our natural hyaluronic acid and this, along with the ageing processes in our skin and fatty layers, results in the loss of volume in our mid-face, or lower and upper cheeks.

Thanks to Restylane, we now have long-lasting, synthetic hyaluronic acid products which are made from non-animal sources and are safe to use in our skin to put back both volume and hydration, where needed. The placement of the hyaluronic acid gel will contour the cheekbone area to bring back that attractive facial profile, whilst also providing lift in the mid-face to correct minor sagging which presents in the jawline. Putting the structural support back into the cheeks with dermal fillers can achieve as significant anti-ageing result, rejuvenating the face.

Restylane comes in different formulations or ‘thicknesses’ so we can use it in different areas of the face, but also in layers within the skin tissue to achieve different structural support, for maximum benefit. It comes with lidocaine within the syringe, alongside the hyaluronic acid, so has a built in local anaesthetic to make injection more comfortable.

All Restylane products are temporary, so this is a far cry from permanent dermal fillers or implants, making the products much safer than past solutions. You can expect the results to last between 6 and 12 months, depending on the cheek correction required and which specific product we use to treat the area. The amount of correction needed to address the volume loss in the cheek will also determine the optimum number of syringes of Restylane that are needed to achieve the result that you are looking for. Over time your body will naturally metabolise the synthetic hyaluronic acid so long-lasting results can be achieved with regular maintenance treatments, here at Aesthetics clinic to top-up the correction.

If you want to discuss if dermal fillers are the right treatment for you, then please call 01438 300111 to book and appointment to see Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire.

Dr Harry Singh explains why botulinum toxin injections, using Azzalure™ could be the right solution for you when you smile and show too much gum.

A smile is a beautiful thing. It signals an emotional response of joy and happiest, or amusement to those around us. A smile is commonly said to ‘light up someone’s face’. But sadly, some people don’t like their smile, and this isn’t always because they don’t like their teeth. Some people feel that when they smile they show too much of their gums, usually above their top teeth, or that their gums looks too prominent compared to their teeth – this is referred to as a ‘gummy smile’ or an ‘excessive gingival display’ if you want to be technical.

Having a gummy smile can make a person feel self-conscious and less willing to smile, especially in social situations or in photographs, so the beautiful expression of their emotions is stifled. If this is your concern, then keep reading and learn how we can effectively treat this.

When it comes to remedies for a gummy smile, the traditional route, available to dentists and their patients was fairly invasive and involved a procedure called a ‘gingivectomy’. Basically, this is oral surgery to reduce the look of a gummy smile by removing gum tissue. All in this is costly for the patient, painful and requires time to recover and is a radical approach to what is in the main a cosmetic problem. (Gingivectomy is appropriate for some medical and dental conditions however).

Thankfully, we now have botulinum toxin products, and at my clinic in Stevenage, Hertfordshire, we use a brand called Azzalure. Most people are familiar with the use of Botox or botulinum toxin as a cosmetic solution for wrinkles such as frown lines and crow’s feet, but these anti-wrinkle injections can also be used in all sorts of places, and for various medical problems where muscle spasms are causing a variety of conditions.

Using Azzalure as a solution for reducing a gummy smile can be prescribed for you after a face-to-face consultation and discussion with me, Dr. Harry Singh. I will ask you to smile and will review your concerns about how much gum is on show. As a dentist I will be able to assess if this option is right for you and we can discuss whether other dental concerns are also affecting your smile and whether these require addressing, to create a treatment programme that will give you an effective solution.

The botulinum toxin injections would be used to reduce the strength of certain muscles around your mouth to depress your lips when you smile, in other words, we weaken the muscles a little so that your lips do not rise as high above your teeth when you smile. This is achieved by injections of very small doses of the Azzalure into four specific points. It’s important that you go to an advanced practitioner for treatment like this as they must understand the anatomy of the muscles around the mouth, and the dose of botulinum toxin required to correct the gummy smile but not impact on the general movement of the mouth or your ability to smile, chew, talk, drink, kiss etc.

Treatment for a gummy smile with botulinum toxin is not a permanent solution but will last for approximately 4 to 6 months and will require regular, repeat treatments to maintain your ‘new smile’.

So, if you’re self-conscious in your selfies due to a gummy smile please arrange a consultation appointment with me, Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire and we can discuss if Azzalure injections are the right solution for you. Please call us on 01438 300111.

Dr. Harry Singh explains how axillary hyperhidrosis or excessive underarm sweating can be controlled with Botox

If you are troubled by extra or excessive underarm sweating, all year round, then you may have a condition called hyperhidrosis. This is the medical name used to describe a situation whereby someone sweats more than their body really needs to, to regulate heat, and this is most noticeable in the underarms or axilla. Some people also suffer from chronic sweating of their brow, feet and even sweaty palms on their hands. All sorts of treatments are available for the different types of hyperhidrosis, but at his clinic in Hertfordshire, Dr. Singh specialises in consulting with patients who think that they might have a problem with axillary hyperhidrosis – excessive underarm sweating.

Of course, there are different levels of axillary hyperhidrosis, and it affects different people in differing ways. For some, they just don’t like to sweat too much, hate the feeling of underarm wetness, the stains it leaves on their clothes, and this becomes more of a cosmetic concern. For others, this is a socially limiting condition which has a significant affect on their daily working and social lives, with constant use of deodorants, regular changes of clothing and anxiety in social situations where their sweating may become apparent through body odour or sweat marks on clothing.

But there is a solution for both types of people, and this is something that you can discuss with Dr. Singh during a face-to-face consultation with him in clinic. He can treat excessive underarm sweating with botulinum toxin or Botox® injections.

If you are diagnosed as being hyperhidrotic then botulinum toxin can be used to block the signals from the nerves in the armpit to the sweat glands, called eccrine glands. This means that by stopping this communication for between 3 and 9 months, depending on the individual, we can prevent the eccrine glands from producing sweat. During this period there will be reduced wetness and almost no need for anti-perspirants. Over time the effect of the botulinum toxin does where off, this is not a permanent cure, so repeat injections are needed to maintain the relief from excessive sweating.

Hyperhidrosis can affect both men and women in equal measure; it is estimated to affect around 3% of the worldwide population, often starting after puberty or in adolescence. During your consultation you will be able to discuss just how much it effects your life and whether botulinum toxin injections are the right solution for you.

During your assessment and eventual treatment, Dr Singh will review how profusely you sweat, and exactly where the sweating is more acutely located. This will become the target area for the delivery of the tiny injections of small doses of toxin to the sweat glands. It takes from 48 hours to about a week to start to work and reduce the production of sweat to a more comfortable level. Some people stop sweating completely. The length of time that it lasts will vary but you should expect to return for repeat treatments a couple of times a year.

It can be a truly life saving option for many people, giving them back freedom to wear the clothes they want, reduce their reliance on multiple deodorants or specialised antiperspirant products and enjoy social interactions without the fear of sweating.

If you want to discuss excessive sweating and how it affects you, then please call 01438 300111 to book and appointment to see Dr. Harry Singh at Aesthetics in Stevenage, Hertfordshire.